Individual provider Active NPI

Jennifer Yang, PA-C

  • Physician Assistant
  • North Wales, PA
National Provider Identifier
1407366958
Registry record updated Oct 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1144393 Issued in PA
Practice address
152 Jonathan Dr
North Wales, PA 19454-1451
Phone
(215) 361-1876
NPI assigned
Oct 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1144393 PA Primary

Addresses

Primary practice location

152 Jonathan Dr
North Wales, PA 19454-1451

Mailing address

152 Jonathan Dr
North Wales, PA 19454-1451
Phone (215) 361-1876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180305002136 DC Practitioner - Physician Assistant 3476814690 Reassigns benefits to 2 organizations
I20180619002128 MD Practitioner - Physician Assistant 3476814690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1406 Crain S Hwy 106
Glen Burnie, MD 21061-4086
Phone (410) 768-6440

25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Phone (240) 434-4088

29955 Three Notch Rd
100 MMG at Charlotte Hall
Charlotte Hall, MD 20622-3159
Phone (301) 290-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.97 of 100Reported as group
Quality
72.87
Promoting interoperability
100
Improvement activities
40
Cost
67.82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1144393PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Jun 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jun 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Jan 27, 2018 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

29955 Three Notch Rd
Ste 100
Charlotte Hall, MD 20622
Phone (301) 290-5300

25500 Point Lookout Rd
Leonardtown, MD 20650
Phone (301) 475-6106

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507593600000",
    "number": "1407366958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 JONATHAN DR",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541451",
            "telephone_number": "215-361-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 JONATHAN DR",
            "city": "NORTH WALES",
            "state": "PA",
            "postal_code": "194541451",
            "telephone_number": "215-361-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "1144393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wales, PA

Sources for this page

Verify at the official NPI Registry.